Bakgrund: Enligt nationella patientenkäten är patienterna nöjda med vården, däremot skattas inte delaktigheten lika högt.  Ett sätt att öka delaktigheten är personcentrerad vård, som dessutom kan ge en mer effektiv vård med högre kvalitet.  Syfte: Studiens syfte var att beskriva och analysera ett förbättringsarbete om att öka patientens delaktighet genom införande av personcentrerad vård på en kardiologisk vårdenhet. Metod: Förbättringsarbetet genomfördes enligt Nolans förbättringsmodell. Studien var en fallstudie med induktiv ansats. Kvantitativ datainsamling skedde genom enkäter till patienter och medarbetare före och efter fem månaders förbättringsarbete. Kvalitativ datainsamling skedde genom foksugruppsintervjuer med medarbetare. Resultat: Enkäterna visade inga tydliga skillnader efter fem månaders förbättringsarbete. Både patienter och medarbetare skattade patientdelaktigheten högt. Det som skattades lägst av båda grupper var hänsynstagande till arbete, levnadsvanor och tidigare erfarenhet av sjukhusvård. Fokusgruppsintervjuerna visade att välinformerade patienter i större utsträckning kunde vara mer delaktiga. Medarbetarna fick en bättre förståelse av patienten, samtidigt fanns oro över att missa viktig information. Viljan fanns till personcentrering, men förutsättningarna saknades. Slutsats: Förbättringsmodellen är lämplig för införande av personcentrerad vård för att kunna testa vad som fungerar praktiskt. För att lyckas behövs tid och stöd från ledningen. Medarbetarna behöver träning, coaching och få vara delaktiga i förbättringsarbetet.

Bakgrund: Akuta försämringstillstånd i hemmet hos de mest sjuka äldre inträffar ofta. Det är inte ovanligt att flera olika vårdverksamheter är inblandade i vården kring denna grupp vilket ställer krav på en fungerande samverkan. Sjuksköterskor inom flera verksamheter möter de äldre vid akuta försämringstillstånd vilket skapar behov av en fungerande samverkan. Syfte: Syftet med studien var att belysa upplevelser av samverkan bland sjuksköterskor verksamma inom kommun, primärvård, ambulans och akutmottagning i samband med att de mest sjuka äldre blir akut försämrad i sitt hem. Metod: Kvalitativ metod med fokusgruppsintervjuer med sjuksköterskor som hade erfarenhet av samverkan kring de mest sjuka äldre vid akuta försämringstillstånd i hemmet. Intervjuerna analyserades enligt Burnard (1996) innehållsanalys i fyra steg. Resultatet: Analysen resulterade i två huvudkategorier samt sex underkategorier. Huvudkategorin Ensam i teamet presenteras i underrubrikerna Att företräda de mest sjuka äldre, Avsaknad av bedömning på plats och Interaktion med kollegor. Huvudkategorin Jakten på information presenteras i underrubrikerna Betydelsen av information om de mest sjuka äldre, Avsaknad av gemensamt IT-stöd och Behov av att dela information. Slutsats: Sjuksköterskorna upplever samverkan som en nödvändighet vid akuta försämringstillstånd av de mest sjuka äldre i hemmet. Samverkan visar sig dock vara kantad av barriärer. För att kunna bedöma och möta behoven hos de mest sjuka äldre i dessa situationer efterfrågar sjuksköterskorna en förändrad struktur för teamsamverkan, förbättrad kommunikation och informationsdelning. Detta skulle gagna samverkan och den personcentrerade vården. / Background: Reduced general condition at home among the most frail elderly are common. Collaboration of care is necessary as many different health care providers often are involved. Since nurses often meet the most frail elderly in their home in these situations they dependent ona well-functioning collaboration between the health care providers. Aim of this study was to elucidate nurses experiences of collaboration of care around the mostfrail elderly when reduced general condition at home. Method: Qualitative focusgroupinterviews with fifteen nurses from community based care,primary care, ambulance care and emergency care with experience of caring for the most frailelderly and collaboration of care in the elderly’s home. According to the qualitative contentanalysis described by Bernard (1996) the focusgroupinterviews were analysed. Result: The result consists of the two main categories Alone in the team and The pursuit forinformation and the six subcategories To represent the most frail elderly, Absence of medicalassessment, Interaction between colleges, The importance of information, Absence of shared ITsystem and The want of sharing information. Conclusion: Nurses consider collaboration of care as necessary amongst the most frail elderlywhen reduced general condition at home. The result indicate that collaboration of care is difficultto achieve. To meet the needs of the most frail elderly in these situations nurses desires a changein structure to provide for team collaboration, approvement in communication and in sharinginformation. According to nurses, this would benefit collaboration of care and the personcentered care.

The older population in Thailand is growing, and the number of older people who suffer from health problems is increasing as well. The health situation of the older population challenges healthcare providers to care for older people. Healthy aging is key to promoting the health of older people and sustaining their well-being. However, little is known about healthy aging in Thailand, especially in northeastern Thailand, or the Isan region, where the number of older people is increasing. Thus, this thesis aims to understand the factors associated with perceived health and healthy aging and how older people and their relatives in the Isan region conceptualize healthy aging. This thesis also focuses on how community nurses experience the meaning and promotion of healthy aging in this region. This thesis includes four studies. The first is a quantitative cross-sectional study with 453 participants aged 60 years or older. The second and third studies are qualitative with a phenomenographic approach that is based on lifeworld theory. Participants in the second and third studies include 17 older people and 14 relatives who are responsible for caring for older people, respectively. The fourth study is a qualitative study that involves focus group interviews with 36 community nurses who work with older people in the Isan region. The findings of the first study show a variance (24.3%) in perceived health and healthy aging based on residential area, marital status and disability status. The meaning of healthy aging, which was derived from the second, third and fourth studies, was divided into three domains: being interconnected; being able to do something good and feeling strong; and thinking beyond the capacity and functions of body and mind. The promotion of healthy aging was described as “providing health assessments”, “sharing knowledge”, and “having limited resources”. The findings of the first study revealed the key factors that will help healthcare providers promote healthy aging. The findings of the second, third and fourth studies revealed that older people, their children and grandchildren, and community nurses attach different meanings to healthy aging. The finding regarding promotion of healthy aging emphasizes that the person-centredness should be integrated in practice when promoting healthy aging. The results of this thesis will be useful to policymakers, who can apply this enhanced understanding of healthy aging to develop healthcare practices that promote healthy aging.

Syftet med studien var att kartlägga åsikter kring ett Gemensamt Konstruktivt Medarbetarskap (GKM) för att lägga grunden till en plattform att stå på inför kommande arbete kring medarbetarskap ute i organisationer. Studien är en kvalitativ undersökning med fallstudie som grundläggande design med en ansats av positiv psykologi, vilken genomfördes på en kemisk industri. Datainsamlingen gjordes genom fokusgruppsintervjuer där fyra-sex deltagare deltog/intervju. Vid intervjuerna diskuterades fyra fokusområden; gemensamt medarbetarskap, ledarskap, medledarskap och coaching. I studien har fem teman definierats vilka kan utgöra en plattform att stå på; ansvarstagande, förtroende, kommunikation, samarbete och engagemang. Grunden till en plattform består av fem ord som kan ses som ett gemensamt språk för att kunna kommunicera vidare; förtroende, ärlighet, pålitlighet, ansvarstagande och kommunikation. / The purpose of the study was to try to make a chart of views around a Common Constructive Empowerment (CCE) in order to set base for a platform to stand on due to further work around empowerment in organizations. The study is a qualitative research with a casestudy as a fundamental design with an approach to positive psychology, which was carried out in a chemical industry. The data collection took place in focused group interviews with four to six participants/interview. At these interviews four focus areas were discussed; common empowerment, leadership, shared leadership and coaching. In the study five themes has been defined that can be seen as a platform; responsibility, confidence, communication, cooperation and commitment. The base for a platform consists of five words that can be seen as a mutual language in order to keep on with the communication; confidence, honesty, reliability, responsibility and communication.

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Abstract This thesis is both an empirical and theoretical contribution to the study of tax-compliance by taxi-operators and drivers. The exploratory case-study adopts a critical sociological perspective in assessing the limits of both the currently dominant academic literature and the industry-specific legislation on tax conformity, including the most recent strategies and explicit tax-compliance measures from the Australian Tax Office (ATO) with regard to Australian cab-drivers. The core premise of this thesis is that the social and economic activities (both legal and illicit) of cab-drivers are embedded within unique networks of social relations. The study utilises focus-group interviews to explore cabbies’ views on taxation, their perceptions of fairness and trust, and to elucidate how individual taxi-workers justify circumvention of Australian tax laws and regulatory measures in their actual work-practices. This exploration is achieved by analysing the verbal accounts and conversations among cab-drivers that involve their guilt-free justifications for non-compliance. The analysis presents further insights into their “vocabulary of motives” and “aligning actions” vis-à-vis non-compliant tax behaviour. The respondents’ views and perceptions about trust, and distributive and procedural justice, are compared and contrasted against the tax-regulator’s views and the ATO’s current enforcement measures. This study is semi-grounded and qualitative in approach, and is a first contribution to a field of inquiry that appears to be dominated by quantitatively-oriented criminological and social-psychological approaches. In contrast, the case-study presents a sociologically-inspired inquiry, by emphasising that cab-drivers are subjected to a multitude of structural arrangements and social control mechanisms, which influence their attitudes and actions with regard to non-compliance. Moreover, current regulatory initiatives towards diminishing non-compliance in the taxi-industry tend to neglect the concept of “mixed-embeddedness” and the inter-relatedness between tax rules, concomitant enforcement practices, and the nation’s broader legislative framework. The state’s regulation of tax-compliance behaviour of taxi-drivers cannot strictly be detached from other laws and regulatory measures in areas such as taxi-cab licensing, occupational health & safety (OH&S) or industrial & workplace relations, which affect every taxi-operator and contracted driver, albeit in different ways. A social-action approach that grasps more comprehensively the rich contexts and complexities involved in the informal behaviours of cabbies may be regarded as an additional and powerful information tool in the governance of modern taxation systems. The study will demonstrate how serious tensions and contradictory forces arise when tax regulators attempt to enforce a National Compliance Model which is, of itself, inherently mal-integrated and underpinned typically by a bureaucratic ‘one-size-fits-all’ enforcement approach in regard to local networks of taxi-drivers. It will be argued that legislative changes to the (legal) employment status of Australian taxi-drivers may produce a far more expedient and cost-effective way for curtailing the enduring and deeply imbued tax non-compliant modus operandi within this particular sector of Australia’s transport-services industry.

Bakgrund Vid palliativ vård är ett av de grundläggande målen att identifiera och lindra smärta och andra besvärande symtom. Studier har visat att patient och vårdpersonal skattar patientens symtom olika, vilket visar på vikten av att genom systematisk symtomskattning få kännedom om patientens symtom. Patienter i palliativ vård har ofta komplexa symtom som påverkar varandra sinsemellan, och är samtidigt påverkade av sin sjukdom så att möjligheten att själv skatta symtomen försämras. Ett antal olika symtomskattningsinstrument (SSI) kan användas vid palliativ vård, och symtomskattning är en av de kompetenser som ingår i sjuksköterskans ansvarsområde. Dock visar resultat från Svenska Palliativregistret att de målnivåer för symtomskattning som Socialstyrelsen rekommenderar är långt ifrån att uppfyllas. En förutsättning för att kunna öka frekvensen av symtomskattning och därmed även vårdkvaliteten, är att få en större förståelse för vilka faktorer som bidrar till detta, genom att studera sjuksköterskors perspektiv på att använda SSI vid palliativ vård. Syftet var att beskriva sjuksköterskors perspektiv på att använda SSI vid allmän och specialiserad palliativ vård. Metod för studien var kvalitativa semistrukturerade fokusgruppsintervjuer med sjuksköterskor från hospice, avancerad sjukvård i hemmet (ASIH) och allmän hemsjukvård. Alla tre intervjuerna hade fyra deltagare och varade mellan 55 - 57 minuter. Intervjuerna spelades in och transkriberades. Data analyserades med kvalitativ innehållsanalys. Resultatet består av fyra kategorier: 1. SSI innebär en kvalitetssäkring, 2. Sjuksköterskans arbetssätt med SSI är viktigt för resultatet, 3. Hinder och begränsningar i användningen av SSI, och 4. Organisationens betydelse i arbetet med SSI. Slutsats Resultatet visar att sjuksköterskorna upplevde att användandet av SSI kan innebära en kvalitetssäkring av vården, men är inget heltäckande verktyg som kan användas i alla situationer och kan inte ersätta klinisk erfarenhet. Sjuksköterskans kunskap om SSI är avgörande för utförandet, varför utbildning i SSI för sjuksköterskor inom palliativ vård, men även för övriga professioner i teamet kring patienten, är av stor vikt. Organisationen spelar en viktig roll i att se till att rutiner och etablerade arbetssätt finns. Fortsatt forskning bör därför vidare undersöka vilka kunskaper sjuksköterskor anser sig behöva för att kunna använda SSI på ett effektivt sätt.

The general purpose with this study was to investigate what happens when several different participants engage in the process of communicating a mutual message throughout a common paper. With “Skellefteå-tidningen” an official paper from the the municipality of Skellefteå, as an example, both the sender (i.e. the editorial staff) and the receiver (i.e. the reader) perspective is studied and analyzed. The result of these two perspectives are compared to see if the intended sent message is the message that the reader of the paper interpret.   The aim of this study was to investigate how the concerned parties within the municipality of Skellefteå cooperate to make a common product with a mutual message and purpose. The study also aimed to investigate how the citizens of Skellefteå, the receivers of the paper, experience the sent message. The material this study is based on was collected through qualitative interviews with the senders of the paper and focus group interviews with representatives from the receivers. In this study we have used both organizational communication theories and theories on uses and gratifications.   The result of the study indicates that concerned parties within the municipality of Skellefteå have different views on how they want to convey the general message in the paper. Some want the message to focus on Skellefteå as a place while the others want to focus on how and what the municipality of Skellefteå do as a government agency. The senders of the paper, despite their different view on how to send the message, agrees that the general message within the paper should be that Skellefteå is a great place where you can be proud to live. The results also shows that this is in fact the message that the readers interpret after reading the paper. The study show that the paper Skellefteå-tidnignen is a product that fills its purpose. It offer the reader a wide range of material to read and therefore the reader can, with the paper, fullfil many different needs. One other conclusion of this study is however that the senders have difficulties in making the citizens of Skellefteå open and read the paper.

School evaluation has increased in importance in recent years, particularly at the level of the whole school. It is the process which assesses the worth and merits of the institution. Due to the fact that, in most cases, evaluation is judgemental, the notion of Whole School Evaluation (WSE) was introduced into the South African education system by the national Department of Education after the 1994 democratic election. WSE has since then became the official evaluation system in South Africa. In WSE schools undergo internal as well as external evaluation. The results of the evaluation are then used by schools to draw the School Improvement Plans which are aimed at school improvement. This study explores the implementation of WSE in rural primary schools in Limpopo Province. A literature study investigated school evaluation within the international and the South African context, the provision of education in Limpopo Province and existing models of WSE. Against the background of the conceptual framework provided by the literature, a qualitative investigation was done in four primary schools in the Vhembe district in Limpopo Province. Data were gathered by means of in-depth interviews with principals of schools and supervisors. The researcher also conducted focus group interviews with School Management Team (SMT) members from participating schools. Data was analysed, discussed and synthesized. Analysed data revealed the following findings: schools experience difficulties in conducting self-evaluation, educator development in rural primary schools in Limpopo is a problem and the district and the Department of Education do not assist schools concerning development after WSE has been conducted. As a result of these findings, there is a need to assist schools in their development endeavours after WSE. The district officials as well as supervisors should find ways and means of assisting schools in the route to development. Areas for further investigation that would enhance WSE in rural primary schools have been identified. Finally, the conclusion is drawn that schools need to be rehabilitated after WSE. This will assist in developing the whole institution and improving the level of education in South African schools. / Educational Studies / D. Ed. (Education Management)

With a projected increase in electricity demand and low-carbon energy generation in the UK, expansion of the existing transmission grid network is required. In going beyond the NIMBY concept, Devine-Wright (2009) posited a place-based approach that highlights the roles of place attachment and place-related symbolic meanings for understanding public responses to energy infrastructure proposals. This PhD research investigated two overarching and interrelated research aims. The first sought to enlarge our understandings of the processes of attachment and detachment to the residence place by investigating the dynamics of varieties of people-place relations across the life course (people's 'life-place trajectories'), thus addressing the limitation of studies adopting a 'structural' approach to the study of people-place relations. This research, in a second instance, sought to better understand the role of people's life-place trajectories and a range of project-based factors (i.e. procedural and distributive justice) in shaping people's responses to a power line proposal. This research focussed on the Hinckley Point C (HPC) transmission line proposal and residents of the town of Nailsea, South-West England. A social representations theory framework was usefully applied to this research by acknowledging that people's personal place relations and their beliefs about proposed place change, are situated and embedded within wider social representations of place and project. A mixed methods approach was employed comprising three empirical studies. The first consisted of twenty-five narrative interviews, the second a set of five focus group interviews, and the third a questionnaire survey study (n=264) amongst a representative sample of Nailsea residents. Triangulating findings across the three studies produced a novel set of key findings. By elaborating five novel 'life-place trajectories', this PhD research moved beyond structural approaches to the study of people-place relations and made a novel contribution to our understandings of the processes and dynamics of attachment and detachment to the residence place across the life course. This research further confirmed the existing typology of people-place relations and revealed a novel variety termed 'Traditional-active attachment'. Life-place trajectories were instrumental in informing divergent representations of the nearby countryside which were more or less congruent with objectified representations of the HPC project. Future studies investigating place and project meanings should be sensitive to these trajectories. Interestingly, place as a 'centre of meaning' rather than a 'locus of attachment' (or non-attachment) emerged as particularly salient for understanding responses to the project. Project-based factors were salient in informing participants' responses toward the project. A perceived imbalance between high local costs and an absence of local benefits was seen to result in distributive injustice and opposition toward the project. However, improved perceived procedural justice following National Grid's announcement of siting concessions in the spring of 2013, was seen to ameliorate local trust in the developer and project acceptance.